In this video, Nitya E. Abraham, MD, and Joseph Kim, MD, discuss the background and notable findings from the recent Journal of Urology study, “Food Insecurity is Associated with Urge Urinary Incontinence: An Analysis of the 2005-2010 National Health and Nutrition Examination Survey (NHANES).” Abraham is an associate professor of urology, female pelvic medicine, and reconstructive surgery and Kim is an incoming PGY-1 resident at Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York.
Please describe the background for this study.
Abraham: At Montefiore Medical Center in the Bronx, we take care of a lot of people who are from lower socioeconomic backgrounds; up to 40% of our patients live in a high-poverty neighborhood. It made us start to wonder about how those conditions affect their urologic disease, and we thought it'd be interesting to look on a broader level. We've previously looked at how socioeconomic status affects overactive bladder severity or the association between the two. We found that those of a lower poverty-income ratio, those of lower socioeconomic status had higher prevalence of overactive bladder and more severe overactive bladder. Then we thought we could explore it in more detail, and specifically look at food insecurity, especially since diet can affect overactive bladder. There are certain bladder irritants; for example, caffeinated drinks, spicy foods, carbonated beverages. All of these things could potentially be bladder irritants, that would affect overactive bladder severity, and we were interested in studying it in more detail on a broader level.
What were some of the notable findings? Were any of them surprising to you and your coauthors?
Kim: We looked at almost 15,000 participants in our study, of which around 19% had reported some food insecurity within the past year. We found that there were some dietary differences between those 2 groups, including that food insecure participants reported significantly higher rates of consumption of carbohydrates, sugar, water intake, and less fat, protein, and fiber. However, we found that this difference wasn't clinically significant; they were more miniscule differences. Our main finding was that participants who experienced food insecurity in the past year were at 55% increased odds of reporting at least 1 episode of urge urinary incontinence in the past month, compared with those who have not experienced food insecurity. That was statistically significant. And this was even after controlling for demographics, socioeconomic factors, behavioral factors, and medical factors. What we found surprising was that our initial hypothesis going in was that food insecurity would affect urge urinary incontinence through higher intakes of bladder irritants such as caffeine or alcohol. But we found that that was actually not the case and that food-insecure participants actually consumed less of these bladder irritants compared with those who were food insecure.
This transcription was edited for clarity.